World’s Smallest Pacemaker Brings Big Benefits

04/19/2019

On Tuesday, Bonnie Williams, 77, lacked the energy to leave her house and
wondered if she had much time left on earth. On Wednesday, she had a Micra
pacemaker—about the size of a large vitamin—inserted to treat
her atrial fibrillation. And on Thursday, she went shopping and wondered
how to celebrate how incredible she felt.

“There hasn’t been a significant improvement in cardiac pacing
in decades— until now,” explains Brian Kim, MD, Medical Director
of the St. Jude Catheterization Lab and one of the first in the state
to bring the benefits of the miniaturized pacemaker to patients.

With no wires or electrical leads, the tiny self-contained pacemaker is
implanted directly into the heart’s right ventricle, allowing most
patients to go home the same day. Inserted by a catheter through the femoral
artery, the Micra requires no surgical “pocket” or incision,
eliminating two of the most common complications.

In fact, Micra’s complication rate is almost 60 percent lower than
traditional pacemakers—and the gains in convenience are equally
impressive. “Patients typically go home the same day and resume
normal activities within 24 hours, compared to standard pacemakers that
require an arm sling for 4-6 weeks to prevent lead dislodgement,”
says Dr. Kim, a boardcertified electrophysiologist who performed Orange
County’s first Micra insertion two years ago, shortly after its
FDA-approval.

While Micra is currently used to treat a limited number of cardiac patients,
most often those with bradycardia, Dr. Kim says that will change. “This
is the beginning of a paradigm shift away from how we have provided pacing
therapy for the last 20 years.”

Bonnie’s grateful for the paradigm shift in her own life. “Dr.
Kim told me these batteries will last about 12 years and then I’ll
need to get a new one,” says the grandmother of 11. “I have
quite a few things left to do.”